Sample_Order_1_CONTRACT_DATA_REQUIREMENTS_LIST.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER MISC

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H

W58RGZ-16-R-0070 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

C001 Technical Report-Study/Services PERFORMANCE PLAN

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MISC-80508B SOW Para 3.1.2 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A SEE BLOCK 16

Reg

Repr o

16. REMARKS:

Block 8: The Government will review and approve/disapprove with consolidated comments within 30 days after receipt. If disapproved the contractor shall correct and resubmit within 30 days after notification of comments.

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied without Export Control Warnings on unclassified drawings and associated lists. See Enclosure 1.

Blocks 10, 12, and 13: The Contractor shall deliver the Performance Plan NLT 30 days after contract award if no subcontractor effort is required or NLT 60 days after contract award if subcontractor effort is required. The Contractor shall submit updates to the Performance Plan when there is a change in the cost and/or schedule.

BLOCK 14 :Notification of delivery shall be made to LSFCDRLS@peoavn.army.mil. The Contractor shall deliver the data electronically to the Logistics Support Facility Management Activity (LSFMA) .

Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity BLDG 3777 Maintenance Row Redstone Arsenal Al 35898

SEE BLOCK 16

15. TOTAL

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

IR Engineer 10/30/2017 John Caraway 10/30/2017 mailto:LSFCDRLS@peoavn.army.mil

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER FNCL

GROUP

C002 Performance and Cost Report

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-FNCL-80912 SOW Para 3.1.3 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

LT MTHLY 60 DAC b. COPIES

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

N/A 0 30 DARP

16. REMARKS:

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied without Export Control Warnings on unclassified drawings and associated lists. See Enclosure 1.

BLOCK 14: Notification of delivery shall be made to LSFCDRLS@peoavn.army.mil. The Contractor shall deliver the data electronically to the Logistics Support Facility Management Activity (LSFMA) . Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity BLDG 3777 Maintenance Row

REDSTONE ARSENAL AL 35898

-5000

IR Engineer 10/30/2017 John Caraway 10/300/17

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C003 System Segment Interface Control Specification ICS

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-SESS-81314A SOW 3.5.3 AMSAM-MLS

INSERT

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

LT

ONR/R SEE BLOCK 16

b. COPIES

SECT. B

8. APP CODE

A

D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

SEE BLOCK

SEE BLOCK

N/A SEE BLOCK 16

Repro

16. REMARKS:

Block 4: See Enclosure A228 for tailoring.

Block 8: The Government will have 60 days after receipt of initial draft to review and approve/disapprove with consolidated comments. If disapproved, the Contractor shall resubmit within 30 days after notification of comments.

Block 9: See Enclosure 1.

Blocks 10, 12 and 13: The Contractor shall coordinate DRAFT ICS with the Government IPT Lead IAW the Development Plan for review and preliminary approval. The Contractor shall deliver the previously coordinated ICS IAW MIS-STD-52406A-IS for final approval and release with the ECP/ERR.

LSFCDRLS@peoavn.army.mil. The Contractor shall deliver the data electronically to the Logistics Support Facility Management

Activity (LSFMA). Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity

REDSTONE ARSENAL AL 35898-

IPT LEAD

15. TOTAL 0 1 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

IR Engineer 10/30/2017 John Caraway 10/30/2017 DD Form 1423-1, 1 Jun 90

TDP OPTION SELECTION WORKSHEET

SPECIFICATIONS

A. CONTRACT NO.

B. EXHIBIT/ATTACHMENT NO.

Enclosure C003

C. CLIN D. CDRL DATA ITEM NO.

DI-SDMP-81493

DI-CMAN-81314

1. ITEM, PROCESS OR MATERIAL

2. COMMERCIAL ITEM DESCRIPTIONS

X

3. DEFENSE SPECIFICATIONS. (X one and complete as applicable)

a. MIL-PRF b. MIL-DTL X c. PROGRAM UNIQUE

(1) Coordinated (1) Coordinated (1)PERFORMANCE X (2) DETAIL

(2) Limited Coordinated

(2) Limited Coordinated X a. System X

a. System Segment

(3) Interim (3) Interim b. Item X b. Item

c. Software c. Software

d. Material d. Material

e. Process e. Process

4. ASSOCIATED DOCUMENTS PER MIL-STD-961. The Following documents associated with defense specifications are required under the CDRL data item number referenced herein. (X and complete as applicable)

a. DOCUMENT b. CDRL DATA ITEM NO. a. DOCUMENT b. CDRL DATA ITEM NO.

(1) Supplements

OPTIONAL

For Classified Data A/R (5) Cancellation Notice

(2) Amendments

(6) Reinstatement Notice

(3) Validation Notice

(7) Military Specification Sheets

(4) Inactive for New Design Notice

5. DELIVERABLE PRODUCT (X and complete as applicable)

a. ORIGINALS

(1) Came a Ready Master

X (2) Digital Data (Detail in item 6, including requirement for diskettes with Portable Document Format or Printer Description Language, and Word

Processing Program.)

6. OTHER TAILORING (Attach additional sheets as necessary)

Product Baseline Detail and Interface Specifications IAW MIL-STD-961D(1) shall use contractor specification numbers.

For final delivery, the Contractor shall submit as 8.5 X 11 inch PDF with no fold-outs IAW MIS-

STD-52406A-IS using Code “BE” for DFIS Sequence number 56.

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER SESS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

C004 Product Drawings and Associated Lists N/A

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-SESS-81000E SOW 3.5.4 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION IN

LT B/D SEE ITEM 16 SEE ITEM 16

b. COPIES

8. APP CODE

SEE BLOCK 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A 16 N/A REV ASREQ

BLOCK 4: See Enclosure C004 for tailoring.

BLOCK 8: The Government will have 60 days after receipt to review and approve/disapprove with consolidated comments. If disapproved, the Contractor shall resubmit within 30 days after notification of comments.

BLOCK 9: See Enclosure 1.

BLOCKS 10, 12 & 13: Preliminary drawings shall be coordinated with the IPT Lead for engineering review and concurrence. Final approved and released drawings shall be delivered with a copy of the approved ERR IAW MIS-STD-52406A-IS NLT 30 days after notification and receipt of ECP/ERR approval.

electronically to the Logistics Support Facility Management Activity

(LSFMA). Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

BLDG 3457 Vincent Road

IPT LEAD

IR Engineer 10/30/2017 John Caraway 10/30/2017

TDP OPTION SELECTION WORKSHEET

PRODUCT DRAWINGS AND ASSOCIATED LISTS

A. CONTRACT NO.

UH-1H

B. EXHIBIT/ATTACHMENT NO.

Enclosure C004

C. CL IN

D. CDRL DATA ITEM NO.

DI-SESS-81000C

1. DELIVERABLE PRODUCT (X and complete as applicable.)

a. ORIGINALS (Specify current design activity's full size reproducible drawing or digital data file(s) on which is kept the revision record recognized as official) (Identify specification, type, grade and class, etc.)

b. REPRODUCTIONS (Identify specifications, type, grade and class, etc., and quantity of each)

The Contractor shall submit full scale Un-dimensioned Drawings or Artwork Master drawings on stable base media

IAW ASME Y14.100 Paragraph B5.1.1.

c. DIGITAL DATA: Contractor shall submit MIL-PRF-28002, Type I, CALS Raster Image Data and all associated metadata IAW MIS-STD-52406A-IS using Weapon System Code "BE" for data element #56.

When Digital 3-D CAD, CAE or CAM files, are produced, they shall be attached as accompanying documents to an associated CALS Raster Image 2-D drawing metadata record.

2. CAGE CODE AND DOCUMENT NUMBERS (X ONE)

X a. CONTRACTOR:

b. GOVERNMENT Complete (1) and (2) or (3)

(1) Use CAGE Code

(2) Use Document Numbers

(3) To Be Assigned By:

3. DRAWING FORMATS AND DRAWING FORMS (X one and complete as applicable)

X a. CONTRACTOR FORMATS. Forms to be supplied by contractor

b. GOVERNMENT FORMATS. Forms to be supplied by contractor.

Samples supplied by UH Configuration Management Officer

e. GOVERNMENT FORMATS. Forms to be supplied as Government Furnished Material by (Specify)

4. TYPES OF DRAWINGS SELECTION (X one)

X a. CONTRACTOR SELECTS FROM ASME Y14.24 b. GOVERNMENT SELECTS (Specify in Item 9)

5. ASSOCIATED LISTS (X and complete as applicable)

X a. PARTS LISTS (X one) X (1) integral OR X (2) Separate - Contractor Choice

b. DATA LISTS (X one) X (1) Not Required (2) Required (Specify levels of assembly)

c. INDEX LISTS (X one) X (1) Not Required (2) Required (Specify levels of assembly)

d. WIRING LISTS (X one) X (1) Not Required (2) Required (Specify levels of assembly)

X e. INDENTURED DATA LISTS (1) Not Required X (2) Required for Top-down Generation Breakdown Drawing List

X f. APPLICATION LISTS (X one) (1) Not Required X (2) Required (To lowest repairable levels of assembly)

6. DETAILS (X one)

X a. MULTIDETAIL DRAWINGS PERMITTED b. MONODETAIL DRAWINGS MANDATORY

7. APPLICABILITY OF STANDARDS. The following Standards apply. (X as applicable)

a. ASME Y14.100

ENGINEERING

DRAWING

PRACTICES

B. X b. ASME Y14.100, W/ APP. B,C,D,E

c. ASME Y14.34

ASSOCIATED LISTS

d. EXISTING STANDARDS

DO NOT APPLY

C. X

D. X

E. X

8. OTHER TAILORING (Attach additional sheets as necessary)

Vendor Substantiation Data is Required for Flight Safety Parts only.

MIL-DTL-31000C FIGURE 1.

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

C TDP TM OTHER CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

C005 Engineering Change Proposal ECP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-CMAN-80639C SOW 3.5.8 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION IN

LT B/D ASGEN SEE BLOCK 16

b. COPIES

SECT. B

8. APP CODE SEE BLOCK 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A 16 N/A SEE BLOCK 16

BLOCK 8: The Government will have 60 days after receipt to review and approve/disapprove with consolidated comments. If disapproved, the Contractor shall resubmit within 60 days after notification of comments.

BLOCKs 12 & 13: Initial submittal shall be not later than 60 days following completion of qualification tests, FCA/PCA and

Government concurrence with all affected documentation except the

ECP and the ERR. Government ECP numbers will be assigned by the UH CMO and provided by the PCO.

data electronically to the Logistics Support Facility Management

AMSAM-MLS 0 1 0

15. TOTAL 0 1 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

IR Engineer 10/30/2017 John Caraway 10/300/2017

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

C TDP TM OTHER CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

C006 Engineering Release Record ERR

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-CMAN-80463C SOW para 3.5.9 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION IN

LT B/D TWICE SEE BLOCK 16

b. COPIES

SECT. B

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A N/A AMSAM-MLS

16. REMARKS: C/M OFFICE 1

Block 8: The Government will approve or disapprove with comments within 30 days after receipt. If disapproved the

Contractor shall correct and resubmit within 30 days of notification

Block 9: See Enclosure 1

Blocks 10 & 12: Deliver initially with each ECP. Initial delivery shall be fully compatible with MS Office Software, with text preferably in MS Word, or any other Government utilized software.

Block 13: Resubmit Government approved PDF copy with released documents IAW MIS-STD-52406A-IS.

data electronically to the Logistics Support Facility Management

Approved Copy See BLOCK 16

0 1 0

Enclosure 1

Distribution Statements

(1) Distribution Statements: All newly created technical documents to be delivered under this contract shall be marked IAW DoD Directive 5230.24 with the appropriate distribution statements as specified in block 9 of the respective DD Form 1423. Appropriate markings are provided below.

Distribution Statement A: Approved for public release; distribution is unlimited.

Distribution Statement B: The Distribution authorized to U.S. Government Agencies only, to protect information not owned by the U. S. Government and protected by a contractor’s “limited rights” statement, or received with the understanding that it not be routinely transmitted outside the U. S. Government, date of determination 9 July

2004. Other requests for this document shall be referred to:

Utility Helicopters Project Management Office

Program Executive Office, Aviation

ATTN: SFAE-AV-UH (Data Manager)

Redstone Arsenal, AL 35898-5000

Distribution Statement C: Distribution authorized to U.S. Government Agencies and their contractors for administrative or operational use, as of 9 July 2004. Other requests shall be referred to:

Utility Helicopters Project Management Office

Program Executive Office, Aviation

Distribution Statement D: Distribution authorized to Department of Defense and U.S.

DoD contractors only, for administrative or operational use, as of 9 July 2004. Other requests shall be referred to:

Utility Helicopters Project Management Office

Program Executive Office, Aviation

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

1 .DATA ITEM

NO.

2. TITLE OF DATA ITEM 3. SUBTITLE

17. PRICE GROUP

C007 Configuration Audit Summary Report

4. AUTHORITY (Data Item

Description No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-DI-CMAN-81022C

Sow Para 3.5.10 AMSAM-MLS

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

LT B/D SEE BLOCK 16 SEE BLOCK 16 b. COPIES

8. APP

CODE

11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A N/A

AMSAM-

MLS

Block 8: Government will have 60 days after receipt of data to review and approve or disapprove with consolidated comments. If disapproved the Contractor shall resubmit within 30 days after notification.

Blocks 10 and 12: Contractor shall submit within 14 days after each audit.

electronically to the Logistics Support Facility Management Activity

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

C008 Request For Deviation RFD

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-CMAN-80640 SOW Para 3.5.11 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION IN

LT B/D ONE/R SEE BLOCK 16 a. ADDRESSEE b. COPIES

SECT. B

8. APP CODE SEE BLOCK 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

AMSAM-MLS

Final

CMO

Draft Reg Repro

16. REMARKS: IPT LEAD 1

Block 8: The Government will have 45 days to review and approve or disapprove with consolidated comments. If disapproved, the contractor shall correct and resubmit within 30 days after notification.

Block 9: See enclosure 1.

Blocks 10, 12 and 13: The Contractor shall coordinate DRAFT RFDs with the Government IPT Lead IAW the Development Plan for review and concurrence. The Contractor shall deliver all coordinated and approved RFDs.

electronically to the Logistics Support Facility Management Activity

See Block 16 1

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER SAFT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

1. DATA ITEM

NO.

2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

C009 Safety Assessment Report (SAR)

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-SAFT-80102B SOW Para 3.7 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

16. REMARKS:

Block 8: Government will have 30 days to review and approve/disapprove with consolidated comments. If disapproved the contractor shall resubmit within 30 days after notification of comments

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied without Export

Blocks 10, 12, and 13: Delivery shall be IAW approved Performance

Plan.

electronically to the Logistics Support Facility Management Activity (LSFMA). Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity

SEE BLOCK 16 1 1 0

1 1 0

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER MISC

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

C010 TECHNICAL REPORT-STUDY/SERVICES Source Material

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80508A Para 3.8.1.1/3.8.1.8 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

ONE/R SEE BLOCK16

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Draft

N/A

SEE BLOCK

N/A

BLOCK 8: The Government will review and comment within

45 days after receipt. The Contractor shall correct and resubmit within 30 days after receipt of comments.

BLOCK 10: The Contractor shall deliver to the Government, the source data as described in this SOW by CD ROM. The source material shall consist of the XML files and CGM illustrations used to create the page changes for this SOW. The

XML files shall conform to the ARSL DTD. Delivery shall coincide with final delivery of Change Pages. Delivered data shall contain the last Government verified generated revision and/or changes.

LSFCDRLS@peoavn.army.mil. The Contractor shall deliver the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

AMSAM-MLS 1

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER ALSS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C011

Logistics Management Information (LMI) Data

Products

Maintenance Allocation Chart (MAC)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ALSS-81530 SOW PARA 3.8.1.1.2 AMSAM-MLSUT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SEE 16 SEE 16

SECT. B

8. APP CODE

B/D

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

A

N/A N/A

BLOCK 8: The Government will approve/disapprove within 45 days after receipt. If disapproved the Contractor shall correct and re-submit within 30 days after notification.

BLOCK 12: The updated MAC shall be provided with each submission of the Draft Equipment Publications and the initial PPL.

Transmission shall be by letter of transmittal.

BLOCK 13: Final submittal shall be concurrent with the submittal

Equipment Publications. Transmission shall be by DD Form 250 the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered

BLDG 3457 Vincent Road

IR Loggie 10/30/2017 John Caraway 10/30/2017

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

C012 Technical Services Report-Study Services Modification Work Order

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80508A Para 3.8.1.2 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16

b. COPIES

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

.Block 8: The Government will review and approve/disapprove with comments within 45 days after receipt. If disapproved the Contractor shall correct and resubmit within 30 days after receipt of comments.

Block 10, 12, and 13: Initial submission of the draft MWO shall be

NLT 45 days prior to delivery of the Verification Kit to the

Government. Subsequent delivery shall be NLT 30 days after successful completion of verification and incorporation of all verification comments into the MWO.

Final delivery of the verified MWO shall consist of a camera-ready copy, a Portable Document File (PDF) and an electronic copy comparable to Word. The illustration files shall be delivered in a verified hard copy and an electronic file using vector-based Computer

Graphic Metafiles (CGM) or similar format. The PDF file shall be delivered in an acceptable font.

Any PPL submitted for this MWO shall be delivered concurrently with draft copies of the MWO.

electronically to the Logistics Support Facility Management Activity

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER X

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

C013 Validation Report Validation Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-CMAN-80792 Para 3.8.1.5 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16

b. COPIES

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

BLOCK 8: The Government will have 45 days after receipt to review and approve/disapprove with comments. If disapproved the Contractor shall re-submit within 30 days after notification of comments.

BLOCKS 10, 12, and 13: The validation report shall be delivered concurrently with the draft deliveries of verified technical manual work packages/changed pages for the DMWR, TMs, RPSTLs and MWO including the DA Form 2028 and publication source data changes that will be used for

Government Verification.

the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintain the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER ALSS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C014

Supplemental Data for Provisioning (SDFP) Supplemental Data for Provisioning (SDFP)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ALSS-81557

SS-81557DI-AL81557

SOW PARA 3.8.2.1

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

AS REQ SEE 16

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

N/A SEE 16

BLOCK 8: The Government will approve/disapprove within 45 days after receipt. If disapproved the Contractor shall correct and re-submit within 30 days after notification.

BLOCK 12: Initial submittal shall be concurrent with initial submittal of the PPL.

BLOCK 13: Final delivery shall be concurrent with final submittal of PPL. Letters of refusal to supply SDFP shall be submitted concurrent with final PPL.

the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered

IR Loggie 10/30/2017 John Caraway 10/30/2017

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER ALSS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C015 Logistics Management Information (LMI) Data

Product(s)

Design Change Notice (DCN)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ALSS-81529 SOW PARA 3.8.2.1 AMSAM-MLS

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

BLOCK 8: The Government will approve/disapprove within 45 days

BLOCK 12: Submittal shall be not later than 21 days after design change approval.

BLOCK 13: Final delivery shall be prepared and delivered within 30 days of receipt of written comments or approval.

the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER ALSS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

C016

Logistics Management Information (LMI) Data

Products

Provisioning Parts List (PPL)

4. AUTHORITY (Data Acquisition Document

No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-ALSS-81529/T

SOW PARA 3.8.2.1.2./3.8.2.1.2.1

AMSAM-MLS

INSERT

7. DD 250 REQ 9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

DLTD

8. APP CODE

A B/D

11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Draft a

16. REMARKS:

BLOCK 8: The Government will approve/disapprove within 45 days after receipt. If disapproved the Contractor shall correct and re-submit within 30 days after notification.

The error rate shall not exceed 2%.

BLOCKs 10, 12, & 13: Initial submittal shall be NLT 45 days prior to the Provisioning Conference. Final submittal shall be NLT 30 days after receipt of approval.

BLOCK 14: Notification of delivery shall be made to LSFCDRLS@peoavn.army.mil.

The Contractor shall deliver the data electronically to the Logistics Support Facility

Management Activity (LSFMA) . Data that cannot be delivered electronically shall be

TOTAL

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER ALSS

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C017

Logistics Management Information (LMI) Data

Products

Provisioning & Other Pre-Procurement

Screening

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ALSS-81529 SOW PARA 3.8.2.1.4 AMSAM-MLS-MMC-AV-UT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

1time SEE 16

SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

N/A n/a

BLOCK 8: The Government will approve/disapprove within 45 days

BLOCK 12: Submittal shall be concurrent with submittal of initial

PPL

the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER ALSS

D. SYSTEM/ITEM W58RGZ-16-R-0070 F. CONTRACTOR

UH-1H TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

C01812

Logistics Management Information (LMI) Data

Products Tool and Test Equipment

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-ALSS-81529/T

SOW Para 3.8.2.3 AMSAM-MLS

INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT

SEE BLOCK 16 SEE BLOCK 16

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

16. REMARKS:

BLOCK 8: The Government will approve/disapprove within 45 days after receipt. If

Blocks 10, 12, and 13: Delivery shall be IAW approved Performance Plan.

BLOCK 14: Notification of delivery shall be made to LSFCDRLS@peoavn.army.mil.

The Contractor shall deliver the data electronically to the Logistics Support Facility

Management Activity (LSFMA). Data that cannot be delivered electronically shall be

IR Loggie

10/30/2017 John Caraway 10/30/2017

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER NDTI

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

17. PRICE

GROUP

C019 Test Procedure Acceptance Test Procedure

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-NDTI-80603 SOW para 3.9.1 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

16. REMARKS:

Block 8: Government will have 60 days after receipt of data to review, approve/disapprove with consolidated comments. If disapproved contractor will resubmit within 30 days after notification

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied without Export

BLOCK 14: Notification of delivery shall be made to LSFCDRLS@peoavn.army.mil. The Contractor shall deliver the data electronically to the Logistics Support Facility Management Activity (LSFMA).

Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity

Redstone Arsenal Al 35898

SEE BLOCK 16 0 1 0

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA. 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP TM OTHER NDTI

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

UH-1H W58RGZ-16-R-0070 TDB

1. DATA ITEM

NO.

2. TITLE OF DATA ITEM 3. SUBTITLE

C020 Test/Inspection Report Acceptance Test Report

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATE

D TOTAL

PRICE

DI-NDTI-80809B SOW para 3.9.1 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES SECT. B

8. APP

CODE

B/D 11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Dra ft

Final

A N/A SEE BLOCK 16

Re g

Re pro

16. REMARKS:

Block 8: The Government will review and approve/disapprove with consolidated comments within 30 days after receipt. If disapproved the contractor shall correct and resubmit within 30 days after receipt of comments.

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied without Export Control Warnings on unclassified drawings and associated lists. See Enclosure electronically to the Logistics Support Facility Management Activity (LSFMA). Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Logistics Support Facility Management Activity

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA.

22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER MGMT

GROUP

C021 Weight and Balance Report for Aircraft

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MGMT-81501 SOW 3.10.2.1 AMSAM-MLS INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

16. REMARKS:

BLOCK 8: The Government will have 30 days after receipt to review and approve/disapprove with consolidated comments. If disapproved the Contractor shall resubmit within 30 days after notification of comments.

Block 9: Distribution Statement “B” for authorized Limited Rights data and Distribution Statement “D” for all other data shall be applied…